Facility Evaluation Report

On 03/19/2024, Licensing Program Analyst (LPA) Brian Phillips conducted an unannounced Case Management - Incident visit to the facility above. LPA met with Administrator Martha Mancha and Residential Counselor Mary Ellen and explained the purpose of the visit.

During the visit on 03/19/2024, LPA observed the facility as well as the Clients in care. LPA conducted record review of documents pertinent to the Case Management Incident. LPA requested the following documents: Client File including most current Physician’s Report, Admission Agreement, most current Regional Center Individual Program Plan (IPP) assessment and/or Appraisal/Needs and Services Plan, most recent Behavior assessment from Regional Center if applicable, hospital visit reports, medical visit reports, facility internal/charting notes on Client, and Emergency/Identification Information. LPA requested LIC 500/Current Staff schedule as of March 2024, reviewed staff member clearance by the Department of Justice (DOJ), Staff member write-ups (positive or negative) if applicable, and LPA received documentation of contact information for Staff members. An Investigations Branch (IB) Service Request referral was submitted on 03/18/2024 and accepted by IB on 03/18/2024.

LPA informed the Administrator additional time will be needed for the investigation. LPA will return at a later time as further investigation is needed.

Exit interview conducted. Copy of the report provided to the facility.